The role of the right ventricle (RV) in the maintenance of normal cardiovascular homeostasis is not clearly defined. Numerous conflicting studies concerning critical illnesses have recently been published. This paper reviews recent scientific advances relevant to our knowledge of RV pathophysiology and dysfunction observed in adult respiratory distress syndrome, pulmonary embolism, acute myocardial infarction and after cardiac surgery. Paediatrics and consequences of surgical repair of congenital diseases have been excluded from this review. Recent advances in thermal dilution technology, echocardiography and nuclear magnetic resonance imaging are also critically analysed.